title: Control of acute postoperative pain by transcutaneous electrical nerve stimulation after open cardiac operations: a randomized placebo-controlled prospective study.
abstract: OBJECTIVE
  We investigated the effectiveness of transcutaneous electrical nerve stimulation (TENS) therapy on pain during the first 24 hours after a cardiac surgical procedure.
  
  
  METHODS
  A total of 60 patients who had undergone median sternotomy (MS) for coronary artery bypass graft (n = 55) or valve repair surgery (n = 5) were randomized to receive TENS and pharmacologic analgesia, placebo TENS and pharmacologic analgesia, or pharmacologic analgesia alone (control group). For each group we recorded severity of pain, analgesic intake, and pulmonary complications. Pethidine HCL and metamizol sodium were administered for postsurgical analgesia.
  
  
  RESULTS
  Pain after MS was measured on a 10-point visual analogue scale (VAS). Mean scores in the TENS, placebo TENS, and control groups, respectively, were 5.70 +/- 1.78, 5.75 +/- 1.83, and 5.95 +/- 1.63 before treatment (P >.05); 2.40 +/- 1.18, 3.90 +/- 1.48, and 3.55 +/- 1.60 on the 12th hour of the intervention (P < .05); and 1.25 +/- 0.91, 2.30 +/- 1.34, and 2.15 +/- 1.13 on the 24th hour of the intervention (P < .05). The mean VAS scores decreased within each group (P < .05). However, the mean VAS scores decreased much more significantly in the TENS group (P < .05). Metamizol sodium intake was 1.05 +/- 0.39 g, 2.30 +/- 1.08 g, and 2.90 +/- 1.20 g and pethidine HCL intake was 17 +/- 16.25 mg, 57 +/- 21.54 mg, and 51.50 +/- 18.99 mg, respectively, in the TENS, placebo TENS, and control groups. Metamizol sodium and pethidine HCL intake was least in the TENS group (P < .05). Postoperative complications were observed in 6 (10%) of patients. The most frequent complication was atelectasia.
  
  
  CONCLUSIONS
  TENS was more effective than placebo TENS or control treatments in decreasing pain and limiting opioid and nonopioid medication intake during the first 24-hour period following MS.
authors.affiliation: Department of Cardiovascular Surgery, Afyon Kocatepe University, School of Medicine, Afyon, Turkey.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Emmiler
authors.forename: Ozlem
authors.initials: O
authors.lastname: Solak
authors.forename: Cevdet
authors.initials: C
authors.lastname: Kocogullari
authors.forename: Umit
authors.initials: U
authors.lastname: Dundar
authors.forename: Ercument
authors.initials: E
authors.lastname: Ayva
authors.forename: Yuksel
authors.initials: Y
authors.lastname: Ela
authors.forename: Ahmet
authors.initials: A
authors.lastname: Cekirdekci
authors.forename: Vural
authors.initials: V
authors.lastname: Kavuncu
mesh_terms: D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D004599:Electric Stimulation Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000175:diagnosis / Q000209:etiology* / Q000517:prevention & control*; D015990:Placebo Effect; D016896:Treatment Outcome